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Bas J.M Peters
EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
EP1.01-36 - Quality of Life in Advanced Lung Cancer Patients in a Dutch Population (Now Available) (ID 2623)
08:00 - 18:00 | Author(s): Bas J.M Peters
In advanced lung cancer chemotherapy is associated with a statistically significant improvement in overall survival (OS) compared to best-supportive care (BSC) alone. The palliative benefit of systemic therapy in incurable cancers cannot be deduced from response rates and survival benefits, but needs to be assessed directly, through validated patient reported tools. Studies have suggested that systemic therapy also improves quality of life (OoL) due to better overall physical functioning and alleviation of cancer-related symptoms. We aimed to investigate the QoL of patients with advanced lung cancer treated with systemic therapy or best-supportive care (BSC) alone in real-world practice.Method
The European Organisation for Research and Treatment of Cancer (EORTC) QOL questionnaire (QLQ-C30) and the EORTC QLQ-LC13 were used to assess patients reported outcome measures (PROMs) at baseline, 3, 6 and 12 months in 235 patients with stage IIIb and IV NSCLC or SCLC diagnosed and treated between Janury 2013 and September 2017 in four large teaching hospitals in the Netherlands. Demographic and baseline data were compared with unpaired T- or c2-tests. Cox proportional hazard model was used to compare survival among these two groups and investigate the influence of age at diagnosis (continuous variable), gender and performance status. The change over time in raw questionnaire scores were analysed by using linear mixed modelling.Result
Systemically treated patients (n=177) had a significantly prolonged OS compared to BSC (median OS of 691 vs 219 days (p<0.0001)) and a higher number of patients in the BSC arm (n= 58) died during the observation period (62.1% vs 44.6%, p=0.02). ‘Physical functioning’, ‘role functioning’, ‘shortness of breath’ and ‘bothered by shortness of breath’ were significantly different between the PST/BSC groups (p<0.001, p=0.025, p=0.017 and p=0.031 resp.) at baseline. Over time there was no significant time-treatment interaction in global health, functional or symptom scores between systemic therapy and BSC (p >0.09 in all cases). Patients deceased during observation had significantly worse global health and functional status and experienced more disease and treatment related symptoms.Conclusion
Treatment with systemic therapy in advanced lung cancer led as expected to longer OS than BSC alone. However, unlike the evidence obtained from clinical trials, the QoL of patients in real-world practice, decreased in both groups equally over time.
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